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Community Service award winner Mary Smania removes barriers to care

Erin F. Wasinger, for the Lansing State Journal
Published 12:16 p.m. ET May 9, 2018

“We have no options” isn’t a viable answer for Mary Smania, a DNP who works with breast cancer patients.

When she hears that line, she said, “I’m like, ‘Yes, we’re going to find an option. We’re going to find it, one way or another, to make sure this person gets care.’”

That determination to help patients no matter their circumstance has earned Smania the Salute to Nurses Community Service Award. “I go to the Nth degree to make sure (patients) are reassured they’re going to have care when they’re diagnosed,” she said.

Smania works at the MSU Department of Surgery Comprehensive Breast Center and is an assistant professor in the College of Nursing. She is also board-certified as a family nurse practitioner and an advanced genetics nurse.

The DeWitt resident has worked in the Lansing area for about the last two decades of her 36-year-long career. She started working in acute care settings, but got into breast cancer research 18 years ago when she returned to college to earn a doctorate degree in nurse practitioning.

After graduation she worked at a health department, where her desire to help underserved and uninsured people was hindered by limitations. The health department could offer some services, she said, “but if (the patient) needed a biopsy or things like that, there were no resources for them in the area. It was just very frustrating for them and for us.”

When she was hired at MSU, she was adamant about removing barriers to care. The breast center’s first Komen grant in 2009 provided mammograms, ultrasounds, and genetic testing for people who otherwise couldn’t afford it. The latest, a grant for 2018-19, defrays the costs for low-income patients with insurance deductibles over $500.

Over the seven years Komen grants have been awarded so far, the clinic reports that it has seen 236 unique patients and 146 return visits. That’s 294 mammograms, 195 breast ultrasounds, 13 breast MRIs, 103 breast biopsies, four breast surgeries, 10 genetic tests/counseling sessions, and five breast cancer diagnoses.

A few cases early on highlighted the urgent need, she said. Three women, the oldest in her early 30s, were diagnosed with breast cancer during the first year of the Komen grants. None of them had insurance.

“It was heartbreaking,” Smania said. “Sometimes I had to stand on my head to get them covered.”

That included phone calls, asking for favors, and following up to ensure each received coverage that wouldn’t land her in bankruptcy.

Colleague Kimberly Anderson praised Smania’s commitment to patient advocacy, education, and taking care of women at one of the most vulnerable points in their life. “Mary will be there to fight for you to the end,” Anderson’s nomination read.

In addition to fighting for individuals’ care, Smania feels passionately about addressing disparities in breast health across populations. Data suggests that while white women are more often diagnosed with breast cancers, African American and Hispanic women are much more likely to die from the disease, she said.

So, she and her team have prioritized partnering with faith-based groups and community centers to educate women about their risks. Going where people already feel comfortable is important, she said.

“It’s a train-the-trainer program about how to reach out to women in their communities to talk about breast health and early detection,” she said. Each “Pink Impact” event is catered to the community in which it’s hosted. Recently at Pilgrim Rest Baptist Church in Lansing, a group of breast-cancer survivors in matching T-shirts -- each read “Worry Ends Where Hope Begins” -- performed a liturgical dance. At Cristo Rey Community Center, the presentation was given twice: once in English, once in Spanish.

The 2018-19 Komen grant will allow her team to increase the number of such events, along with adding a new exercise program for women post-breast cancer diagnosis and treatment.

Smania said she’s motivated by something personal: her grandmother died of breast cancer.

“She was diagnosed when it was too late,” she said, but “she always handled it so well. She’s always on the front of my mind when I take care of women.”